How Marriage Counselling Works

Today we want to lift the hood on the world of marriage counseling and look at one particular approach and how it works. If you’ve ever been curious about what happens in the counseling room or are considering counseling there’s a lot more to it than you might think!

The Mystery of Marriage Counseling

The world of counseling may seem like a mysterious or even intimidating place to those who know little about it. There’s a stigma around mental health itself, and although a distressed marriage is not a mental health problem, we rarely talk about our struggles as a couple. We like to appear like we have it all together and I think us church-going folk are even more prone to this.

But then you do hear the horror stories when things don’t go well and people open up. Some terrible advice comes from people who call themselves counselors.

So then when it comes to choosing a marriage counselor it can be pretty scary because your marriage is a big deal and you don’t want to the wrong person trying to help you with it!

Basic Marriage Counselor Criteria

Now I want to say that this article is not an extended advertisement for our services, but the things I am going to tell you are important facts you need to know, whether you decide to work with someone from my counseling practice or find a local counselor.

The first thing is that not all counseling degrees are created equal. When a person is earning their Master’s degree in order to become a therapist, their school and the degree program they choose will generally orient itself around a particular school of thought.

Of course, there are a plethora of flavors. But when it comes to marriage counseling you should know that there are a number of universities around North America that offer marriage and family therapy programs specifically. These kinds of degrees have less focus on specific mental health problems like anxiety disorders or even addictions, and they focus very much on relationships, how humans interact, how children learn to love and relate to others, on marriage dynamics and on family systems.

So when you choose a therapist the first thing you should filter on is their education: do they have a degree that specializes in marriage and family? And usually you’ll see this in the letters after their last name in that either their degree will look like MAMFT (Master of Arts in Marriage and Family Therapy) or their certifying body will supply MFT credentials like LMFT (Licensed Marriage and Family Therapist). If you’re not sure, ask about the person’s training.

The second thing you want to look for is whether the therapist has a specific approach to marriage counseling that is evidence-based. “Evidence-based” means that they are using a treatment approach which has been tested and tried through research and peer-reviewed journals.

Surprisingly, there are only a handful of marriage approaches that have been rigorously tested in this way, and so if you want to give you marriage the best chance of success you would do well to ensure you are selecting a counselor who uses an evidence based approach. Otherwise you’ll have no idea whether what you’re being told actually works or not.

Probably the two most popular evidence-based counseling approaches are Emotionally Focused Couples Therapy (sometimes called EFT or EFCT) and the Gottman Method. I have taken specific training in both of these, on top of my MFT degree, as has my colleague in my practice, Jesse Schellenberg. They are quite different but very complementary.

Both of us favor EFCT as our preferred approach: about 90% of couples show significant improvements using this approach and we’ll talk more about success rates in a moment, but 90% is incredible.

How EFCT Works

Key Principles

Now, I am going to work hard to break the scientific jargon and psychobabble into English here but there are some key principles in this approach to marriage counseling that are important (Gurman et al, 2015[i])

Collaborative alliance: meaning the couple needs to be coached to become allies in working through their difficulties and working together to discover solutions. The onus is on the therapist to facilitate this. When you take this approach to marriage counseling, the relationship between the couple becomes the “client” or the target of the therapy, rather than each individual spouse. And I am very explicit with couples about this: I tell them, “I am not on your side or your side, I am on the side of your marriage.”

Person centered: In its secular form, this approach views people as being essentially good, and capable of making good and healthy choices. The bond and attachment between the couple is viewed as being essentially good and healthy. In this view everyone has the capacity to have a happy, healthy marriage and the ability to break free from conflict and unhealthy patterns.

Now as Christians we own the problem of sin so I prefer to look at it in the sense of acknowledging that people are created in the image of God, which is one source of goodness, but because of sin we act in ways that are self-serving and self-preserving, rather than loving our neighbor/spouse as ourselves.

So I think about it differently but it still invokes the same interventions. Since we’re made in God’s image we all have the capacity to reflect him in our marriage. It’s just sometimes a bit of struggle getting there. A Christian approach to EFCT also argues that the marriage bond is a universally positive and valuable connection that has the capacity to heal and strengthen individuals. Both EFCT and the biblical worldview see marriage as a powerful place for individual growth[ii].

Patterns of reacting: According to EFCT thinking, problems arise when individuals get “stuck” using certain ways of responding and interacting with each other, such as anger or fear of rejection. Often couples will already be somewhat or very aware of this, saying things like, “We always get stuck on the same issues.” These emotions form unhelpful patterns of acting as a couple, which need to be understood and deconstructed.

Expanding emotional responses. Emotions are the main focus of the therapy as they guide how the couple interacts. “Emotion guides and gives meaning to perception, motivates and cues attachment responses, and when expressed, communicates to others and organizes their response[iii]“.

The therapists helps couples to analyze their emotional responses to conflict and find new ways to express themselves in order to help them move forward. For example if a couple often show anger to each other they can work on expressing the underlying fear or vulnerability which is causing the anger. Positive change comes from expressing new, softer emotions and expressing yourself in new ways, not necessarily from uncovering past trauma or working on old issues.

Goals of EFCT

We have three goals.

First, we want to create a safe, collaborative alliance between the spouses where they are both willing to work on their difficulties. This, by the way, is why we do not do marriage counseling when there is an abusive husband in the picture. That issue needs to be resolved first, because there is no emotional safety for the wife, so making her more vulnerable puts her at greater risk for violence or abuse. This is a very common mistake made by therapists who do marriage counseling without being specifically trained in it.

Second, we want to expand the range of emotions which guide the couple’s interactions. Often they are not aware of all that is going on in their hearts, leading people to act in ways that aren’t helpful just because they can’t get at the root of the problem. EFCT does an incredible job of building emotional intelligence.

Thirdly, we work to restructure the couples’ interactions in a more positive and responsive direction. Meaning, they respond to each other positively and with care and sensitivity. We end up creating a positive interaction cycle.

The Marriage Counseling Process

How do we reach those goals? In EFCT there are nine main steps[iv] and we’ll go through them pretty quickly:

1. 1. Identifying the conflict issues within the marriage. “What brings you to counseling?”
   2. Identifying the negative interaction cycle: figuring out how and why the couple are getting stuck. This requires a very skilled therapist so that you can see exactly what is happening.
   3. Uncovering the unacknowledged emotion relating to the couple’s attachment bond which is underpinning the cycle of interaction for each partner. So, finding out what’s really driving the problem: fear, lack of trust, rejection and so on.
   4. Re-framing the initial problem in terms of the cycle of interaction and the underlying needs. Couples need to see that this cycle has been unknowingly created and that both spouses have fallen “victim” to it in the marriage. This is where you reframe the cycle as the enemy, instead of your spouse being the enemy.
   5. Helping individuals to connect with the attachment needs of parts of themselves they have been ignoring. For example the need for reassurance or comfort, or a sense of shame or unworthiness.
   6. Encouraging each partner to accept the other’s experience and perspective.
   7. Helping each spouse express their needs in relation to the original conflict, in order to restructure the cycle of interaction based on new perspectives and emotions.
   8. With these new perspectives, discovering new solutions to old problems.
   9. Developing new, better cycles and patterns of behavior.

So that’s a very brief rundown of the aims, principles and basic steps involved in EFCT. Let’s talk about the effectiveness of EFCT — how well does this approach work, and what are the specific things that make it work well?

Effectiveness of EFCT Marriage Counseling

EFCT has been shown to be highly effective in alleviating marital distress in couples[v]. You see different results in different places but on the EFCT website they note that 90% or couples show significant improvements and over half of couples finish the therapy with no marital distress at all.

What’s really interesting is that 3 months later, an even higher percentage of couples recover their marriage bond. So it’s not just that you treat the symptoms and then the coupe will slowly fade back towards distress, but it really equips them and transformers their marriage.

Not only that, but EFCT can also help reduce depressive symptoms, and can also improve marital quality even for couples who do not consider themselves distressed. So it can improve marriages which are already going well[vi]. Even relatively happy marriages can still benefit from learning to process and express their emotions more clearly. That’s cool.

Specific Factors Which Make EFCT Effective

Let’s have a look at some of the specific issues which come up in EFCT and which make it work so well.

Softening. Softening is a process where an individual who has previously been very critical of their spouse learns to express the underlying need in less aggressive terms. They learn to express vulnerability and state what they need from their spouse (comfort, support etc) on an emotional level rather than criticizing what the spouse is doing[vii]. This softening effect is a specific factor linked to improved marital functioning during therapy.

Blaming. Moving away from blaming your spouse for the conflict or trying to coerce them into changing, and taking a joint or collaborative stance towards problems was also linked to better outcomes after treatment[viii]. So you go from “You are the problem!” to “Let’s figure out how we got derailed…”

Self disclosure. Research shows that couples who were able to disclose more about themselves and their emotional processes received more support and understanding from their spouse, leading to a stronger bond and a more effective progression through the therapy[ix]. This is where you really create intimacy right? We teach couples how to open up the deepest recesses of their hearts to each other, and how to safely receive that information and respond to it.

Feeling cared for. Belief that your spouse still cares for you despite your marital problems was an important predictor of success before therapy starts[x]. I’ll often ask the question, “What is the glue that keeps you together?” near the start of therapy to assess this.

Forgiveness. A study in 2010[xi] studied couples who had been struggling with serious issues of anger and unresolved hurt for over two years. The found that EFCT was effective in helping couples to forgive each other, which led to increases in trust and overall marital satisfaction.

What’s also cool is that some of the factors which can affect success in other therapy types do not impede the progress of EFCT. These include the couple being older, the man being emotionally un-expressive and the couple holding very rigid or traditional views about marriage. These factors can limit success in other types of therapy but were not a problem in EFCT[xii].

So this is a little longer episode but I hope it has given you some insight. This is not some magical “woo-woo” kind of process but it actually relies on a very strategic approach. What’s amazing is that this approach can adapt to the plethora of different issues that couples present with.

Again, this is not meant to be a long advertisement, but to demystify the process. However, if you are in help do reach out to us via our website and we can talk about getting you into this very effective therapy approach.

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References:

[i] Alan S. Gurman, Jay L. Lebow, and Douglas K. Snyder, Clinical Handbook of Couple Therapy (Guilford Publications, 2015).

[ii] Todd Hardin, ‘Redeeming Emotion-Focused Therapy: A Christian Analysis of Its Worldview, Epistemology, and Emphasis’, Religions, 5.1 (2014), 323–33.

[iii] Susan M. Johnson, The Practice of Emotionally Focused Couple Therapy: Creating Connection, 2 edition (New York: Routledge, 2004).

[iv] Gurman, Lebow, and Snyder.

[v] Susan M. Johnson and others, ‘Emotionally Focused Couples Therapy: Status and Challenges’, Clinical Psychology: Science and Practice, 6.1 (1999), 67–79.

[vi] Johnson and others.

[vii] Johnson and others.

[viii] Johnson and others.

[ix] Johnson and others.

[x] Johnson and others.

[xi] Leslie Greenberg, Serine Warwar, and Wanda Malcolm, ‘Emotion-Focused Couples Therapy and the Facilitation of Forgiveness’, Journal of Marital and Family Therapy, 36.1 (2010), 28–42.

[xii] Johnson and others.

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